Timeout Procedure in Paediatric Surgery: Effective Tool or Lip Service? A Randomised Prospective Observational Study
Errors in the timeout routine go unnoticed by the team in almost half of cases. Therefore, even if preoperative timeout routines are strictly implemented, mistakes may be overlooked. Hence, the timeout procedure in its current form appears unreliable. Future developments may be useful to improve the quality of the surgical timeout and should be studied in detail.
Thromboelastography During Rewarming for Management of Pediatric Cardiac Surgery Patients
Lower MA during rewarming is associated with increased risk of perioperative bleeding. In patients with rewarming MA<45mm, intraoperative platelet transfusion may reduce the risk of subsequent bleeding. Individualized platelet transfusion therapy based on rewarming TEG may reduce the risk of bleeding while minimizing unnecessary platelet transfusion.
Cardiopulmonary Bypass in A Child with Severe Factor XII Deficiency
We report the case of a 14.7 kg girl undergoing CPB with a pre-admission FXII concentration of <1% and aPTT >200 seconds. The child was transfused with fresh-frozen plasma to replenish FXII, allowing safe ACT monitoring of heparin anticoagulation throughout CPB.
Lessons Learned From the First Pilot Study of the Compensatory Reserve Index After Congenital Heart Surgery Requiring Cardiopulmonary Bypass
Compensatory Reserve Index monitoring after CHS with CPB seems feasible and safe. Early changes in CRI may precede meaningful clinical outcomes, but this requires further study.
Updating an Empirically Based Tool for Analyzing Congenital Heart Surgery Mortality
The updated STAT metrics reflect contemporary practice and outcomes. New empirically based STAT 2020 Scores and Category designations are assigned to a larger set of procedure codes, while accounting for risk associated with multiple component operations. Updating STAT metrics based on contemporary outcomes facilitates accurate assessment of case mix.
Cardiac Biomarkers for Risk Stratification of Acute Kidney Injury After Pediatric Cardiac Surgery
Preoperative plasma galectin-3 and NTproBNP and the first postoperative galectin-3 and ST2 levels were independently associated with AKI in children ≥2 years old. The performance of cardiac biomarkers after cardiac surgical procedure is affected by age, and research is required to develop biomarkers for children <2 years old.
Total Circulatory Arrest as A Support Modality in Congenital Heart Surgery: Review and Current Evidence
This review analyzes the history, physiology, techniques of DHCA, as well as other alternative strategies like selective cerebral perfusion and presents the current available evidence.
Avoiding Use of Total Circulatory Arrest in The Practice of Congenital Heart Surgery
In this review we have discussed the various physiological and technical factors involved in conduct of SACP in paediatric cardiac surgery and outcomes with SACP.
Contrast Media Exposure in The Perioperative Period Confers No Additional Risk of Acute Kidney Injury in Infants and Young Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass
For pediatric patients who are soon to undergo on-pump cardiac procedures, there appears to be no need to hesitate in performing the diagnostic imaging investigations requiring CM, or delay CPB after CM exposure. These patients may benefit from increased diagnostic utility without increasing their risk of postoperative AKI.
Nadir Oxygen Delivery During Pediatric Bypass as A Predictor of Acute Kidney Injury
The lowest suitable DO 2i during CPB in the present population undergoing pediatric cardiac surgery was 353 mL/min/m 2. And below this threshold, there was a high probability of inducing CS-AKI.
Tidal Flow Perfusion for the Artificial Placenta: A Paradigm Shift
Parameters of the tidal flow group were comparable with those of DLC. Single lumen jugular cannulation using tidal flow is a promising vascular access strategy for AP support. Successful miniaturization holds great potential for clinical translation to support extremely premature infants.
Switching to Centrifugal Pumps May Decrease Hemolysis Rates Among Pediatric ECMO Patients
These data suggest decreasing rates of hemolysis with centrifugal pumps compared to roller pumps. Since hemolysis was also associated with increased risk of death, these data support the switch from roller to centrifugal pumps at ECMO centers.